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General NPI Number Information
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NPI Number | 1659231058
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Entity Type | Individual
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Provider Name | DR. JUSTIN PAUL FORD
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Gender | Male
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Dates
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Enumeration Date | 11/17/2025
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Last Update Date | 11/17/2025
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Provider Practice Location Address
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Address Line | 2465 IRON POINT RD STE 120
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City | FOLSOM
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State | CA
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Zip | 95630-8754
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Country | US
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Telephone | 916-984-9600
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Fax |
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Provider Business Mailing Address
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Address Line | 2301 H ST UNIT 5
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City | SACRAMENTO
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State | CA
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Zip | 95816-4148
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 112456
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License Number State | CA
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